Targeting allergies to breathe easier

Asst Prof Sanjay Chotirmall with a lung model and allergenic fungi grown on agar plates. Credit: NTU.

Bronchiectasis, a chronic condition in which the lung’s airways become abnormally widened, makes the lungs more prone to bacterial, viral and fungal infections. Though sensitivity to airborne allergens is known to be involved in other chronic respiratory diseases such as asthma, it is still unclear how allergy is related to bronchiectasis.

To shed light on this, an international team led by Asst Prof Sanjay Chotirmall of NTU’s Lee Kong Chian School of Medicine assessed over 200 bronchiectasis patients from Singapore, Malaysia and Scotland for sensitisation to common allergenic microorganisms.

They found high rates of allergies to specific fungi as well as house dust mites, with 58% of the patients showing sensitivity to at least one allergen. Allergic sensitisation was associated with decreased pulmonary function and more severe disease.

Comparing patients from Singapore and Malaysia to those from Scotland, the team also found geographical differences in allergen sensitivities—patients in Asia were more sensitive to house dust mite and the fungal species Aspergillus fumigatus, whereas patients in Scotland showed higher sensitivity to a different Aspergillus species. These differences are likely due to regional factors such as climate, air quality, genetics and lifestyle, the authors say.

“The study suggests that since there are no effective treatments for bronchiectasis itself, using existing treatments for respiratory allergies might stop the condition from worsening and improve the quality of life for affected patients,” says Asst Prof Chotirmall.

The articles “Distinct ‘immunoallertypes’ of disease and high frequencies of sensitisation in non-cystic fibrosis bronchiectasis” and “Immunological corollary of the pulmonary mycobiome in bronchiectasis: the CAMEB study” can be found in American Journal of Respiratory and Critical Care Medicine (2019), DOI: 10.1164/ rccm.201807-1355OC, and European Respiratory Journal (2018), DOI: 10.1183/13993003.00766-2018, respectively.
The article appeared first in NTU’s research & innovation magazine Pushing Frontiers (issue #16, February 2020). 

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